# NATIONAL JEWISH HEALTH

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** NATIONAL JEWISH HEALTH
- **Other names:** National Jewish Health Provider Group
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1801493911
- **Legal business name:** NATIONAL JEWISH HEALTH
- **Authorized official:** MS. VICKI MEDINA (DIRECTOR, MEDICAL STAFF SERVICES)
- **Authorized official phone:** (303) 388-4461

## Contact information

- **Practice address:** 1400 JACKSON ST, DENVER, CO 80206-2761
- **Practice address phone:** (303) 388-4461
- **Practice address fax:** (303) 398-1211
- **Mailing address:** 1400 JACKSON ST, DENVER, CO 80206-2761
- **Mailing address phone:** (303) 388-4461
- **Mailing address fax:** (303) 398-1211

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261Q00000X | Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 10/02/2020
- **Last updated:** 01/18/2021

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 04001905 | — | CO |
| 01 | — | CJ6004 | MEDICARE PTAN | CO |